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Orbital Radiation
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Orbital Radiation

My ophthalmologist has just sent in a referral for Orbital Radiation and I am having a hard time finding information about it.  My eyes are very sore and bulging. I was on Prednisone and it seemed to help the irritation but not the swelling so much. I have been off of the prednisone for 5 weeks and my eyes have been somewhat manageable. I am nervous about the radiation and am hoping that the benefits outweight the risks.
The only things that I know about it are that I will have approx 20 treatmants at a low dose and may have hair loss around the temples. I also had lens implants (Worst Myopic Lens - 10yrs ago in The Netherlands), would the radiation affect them?
Any information would be very appreciated!
Thank you
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Please let us know more.  I cannot comment unless I know what your diagnosis is.  If you have thryoid eye disease, then radiation treatment is one option that is available.  I recommend you see a neuro-ophthalmologist that specializes in thyroid eye disease.  The Mayo Clinic in particular is well known in the field.  These cases are complex and every case is unique.  I would rather not make any comment on risk/benefit for your case since I know no details.  I have recommended this type of radiation treatment for a few patients and they have had pretty good results with essentially no side effects but that is highly dependant on how well the eye is shielded and the skill of the radiation oncologist.  In the end, I would make very sure you are being managed by an ophthalmologist and a radiation oncologist that are very experienced in this field and that are in close communication with each other.  The treatments are extremely low dose generally and that is why so many treatments are needed.  The need for treatment depends on the severity of the disease and whether or not other treatments worked.  Used properly, and in the right situations, it is a generally safe treatment with benetits that outweigh the risks.  Some training programs are in favor of radiation treatments and others are more in favor of other treatments including orbital decompression, so there is no clear concensus across the board.  It may depend on the expert you see.  Regarding the Worst Implants, I would watch very closely for the possible development of catarcts in the next few years especially with all the inflammation around the eyes and upcoming possible radation treatment.

Michael Kutryb, MD
Kutryb Eye Institute
Titusville, FL
321-267-2020
www.kutrybeye.com
4 Comments
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Thank you for your response. I do have severe Graves' Ophthalmolpathy. I was diagnosed in July 08 and my eye symptoms started in Sept 08. My ophthalmologist specializes in ophthalmic plastic and lacrimal surgery and has 25 yrs experience with Graves' Disease. Since I did not want to go back on the steriods, because of the horrible side effects, he is recommending radiation. He said that he would not do orbital radiation until my eyes have stabilized as my optic nerve is not in danger at this time. I do have very high eye pressure, 20/60 in the left eye and 20/30 in the right (constantly changing) and double vision (up, down and to the sides). I have also been on Methotrexate since January and not sure if it is helping, even though I would like to think that it is. I have not yet met with the radiation oncologist, but should be within the next week or so.
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Correction from last post. My ophthalmologist will not do *orbital decompression* until my eyes have stabilized.
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284078_tn?1282620298
It sounds like you are in very good hands.  He seems to be taking a systematic and thoughtful approach.  He will also be able to give you much more info about the radiation treatment than I can.

MJK MD
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